Penis frenuloplasty

What is it?

The problem lies in the foreskin. The foreskin is the sleeve of loose skin which covers the bulb end of the penis (the glans). One end of the sleeve grows from the base of the glans. The other end lies freely over the glans to protect it.

Sometimes the foreskin is very tightly fixed to the under surface of the penis. This can cause discomfort and sometimes pain or minor bleeding during intercourse.

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The operation

In some cases the operation can be done under local anaesthetic. In this case you will get an injection of local anaesthetic at the area of the operation and this will go numb. You will feel that something is happening at the area of the operation, but you will not feel any pain.

It is generally more comfortable to have this operation under general anaesthetic but you can discuss the possibility of local anaesthetic with your surgeon.

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The tight band is lengthened with a small operation. The operation can be done as a day case, meaning that you come into hospital on the day of the operation and go home the same day, or a non-day case, where you will spend two nights or so in hospital.

Any alternatives?

If you leave things as they are, the problems may well get worse. Stretching the band does not work.

A formal circumcision to remove the whole of the foreskin is not needed.

Before the operation

If you know that you have problems with your blood pressure, your heart, or your lungs, ask your family doctor to check that these are under control.

Check you have a relative or friend who can come with you to the hospital, take you home, and look after you for the first week after the operation. Bring all your tablets and medicines with you to the hospital.

On the ward, you will be checked for past illnesses andwill have special tests to make sure that you are well prepared and that you can have the operation as safely as possible.

You will have the operation explained to you and will be asked to fill in an operation consent form. Before you sign the consent form, make sure that you fully understand all the information that was given to you regarding your health problems, the possible and proposed treatments and any potential risks. Feel free to ask more questions if things are not entirely clear.

Any tissues that are removed during the operation will be sent for tests to help plan the appropriate treatment. Any remaining tissue that is left over after the tests will be discarded.

Before the operation and as part of the consent process, you may be asked to give permission for any 'left over' pieces to be used for medical research that has been approved by the hospital. It is entirely up to you to allow this or not.

Many hospitals now run special preadmission clinics, where you visit a week or so before the operation, where these checks will be made.

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After – in hospital

There is some discomfort rather than severe pain. You will be given injections or tablets to control this as required. Ask for more if the pain is not well controlled or if it gets worse. By the end of one week the wound should be virtually pain-free.

You will most likely be able to get out of bed with the help of the nurses after an hour or two despite some discomfort.

A general anaesthetic will make you slow, clumsy and forgetful for about 24 hours. The nurses will help you with everything you need until you are able to do things for yourself. Do not make important decisions, drive a car, use machinery, or even boil a kettle during this time.

You should feel fit enough to go home after an hour or two on the ward.

The wound has a moist dressing which can be removed after 24 hours. You may be wearing net elastic pants to hold the dressing in place.

There will be stitches in the wound which will soften and drop out after 7 to 10 days. Sometimes it can take them a bit longer to drop off. If this happens, let your surgeon know about it, but don't try to remove them yourself.

There may be some purple bruising around the wound which spreads downwards by gravity and fades to a yellow colour after two or three days. This is expected and you should not worry about it.

There may be some swelling of the surrounding skin which also improves in two or three days. After 7 to 10 days crusts on the wound will drop off. Occasionally minor match-head sized blebs (blisters) form on the wound line. These settle down after discharging a blob of yellow fluid for a day or so.

You can wash the wound area as soon as the dressing has been removed. Soap and tap water are entirely adequate. Salted water is not necessary. You can shower or take a bath as often as you want. Wear a dressing to keep your underpants clean. Please ask the nurses about sick notes, certificates etc.

After – at home

You are likely to feel a little sore for a week or so. After about two weeks you should be able to return to your usual level of activity.

You can drive as soon as you can make an emergency stop without discomfort ie after about three days.

You can start sexual relations within two to three weeks, when the wound is comfortable enough.

You should be able to return to a light job after a week or so and a heavy job within two weeks.

Possible complications

If you have this operation under general anaesthetic, there is a very small risk of complications related to your heart and lungs.

The tests that you will have before the operation will make sure that you can have the operation in the safest possible way and will bring the risk for such complications very close to zero.

Complications are rare and seldom serious. If you think that all is not well, please tell the doctors or nurses.

Minor bleeding can occur but can usually be stopped by applying some extra pressure on the side of the wound. In some cases you may need another operation to stop the bleeding.

Infection is a rare problem and settles down with antibiotic tablets in a week or two. Although rare, if the infection is much more serious and spreads through your bloodstream, you will need to remain in hospital so doctors can give you intravenous antibiotics (through a vein in one of your arms).

You may get painful erections in the first two or three days. These can be controlled with painkillers.

Damage to the glans or the urethra (the pipe that drains the urine from your bladder to the outside) happens very rarely and another operation is needed to fix the problem. This is successful most of the time.

Aches and twinges may be felt for up to two months.

General advice

We hope these notes will help you through your operation. They are a general guide. They do not cover everything.

The materials in this web site are in no way intended to replace the professional medical care, advice, diagnosis or treatment of a doctor. The web site does not have answers to all problems. Answers to specific problems may not apply to everyone. If you notice medical symptoms or feel ill, you should consult your doctor - for further information see our Terms and conditions.

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